MEDICARE: BRENDA BROWN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WW0000X	Wound Care Registered Nurse	RN243247	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346205234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA BROWN RN

Provider Business Mailing Address
First Line	:	PO BOX 485
Second Line	:
City	:	ROSS
State	:	OH
Zip	:	45061-0485
Country	:	US
Telephone Number	:	513-623-0305
Fax Number	:	513-738-3038

Provider Business Practice Location Address
First Line	:	4871 PROSPERITY PL
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-4027
Country	:	US
Telephone Number	:	513-623-0305
Fax Number	:	513-738-3038

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	07/08/2007

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Directions to “ BRENDA BROWN RN” Practice Location

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